The Correlation European Harm Reduction Network published its first monitoring report (download here!) of harm reduction in Europe. On this occasion, we interviewed Eberhard Schatz, one of the two coordinators of the network about new trends and challenges.
Drugreporter: You have been working in the harm reduction field for a while. How did you get involved in this field?
Eberhard Schatz: I started my work as a social worker and counsellor in Germany, but quite soon I realised that offering people drug-free treatment only – in those days long and heavy psychological and behaviour therapies – was not helpful and sometimes even contraindicated. Failure to finalise such a programme often ended in prison. So we started to advocate for harm reduction, a challenge in the ’80s in Germany. The upcoming HIV epidemic, however, gave a push to harm reduction programmes.
How did you create Correlation and how did it become a European Harm Reduction Network? What is its geographical and thematic focus and role compared to other international networks?
In the ‘90s, I started to work for AMOC, a small NGO in Amsterdam which facilitated foreign drug users in the city from Germany, Italy, other Europeans, and nowadays many people from eastern European countries. We needed to know what the situation of our visitors was in their country of origin (legal, social, support system). That’s why we contacted agencies abroad and started collaboration: in the first instance for mobile drug users and for men working in prostitution. Later, we intended not to focus only on very specific target groups, but to approach more the common issues marginalised and vulnerable groups have in the society: discrimination, exclusion, barriers to accessing services etc. That’s why we founded Correlation – European Network Social Inclusion and Health. Two years ago, however, we changed the name to Correlation – European Harm Reduction Network (C-EHRN). Harm reduction was always in the centre of our efforts to improve the health and wellbeing of the people we work for, but we saw that in the European Union harm reduction was under threat due to political and economic reasons.
C-EHRN has been funded during all these years through EU programmes. We are very grateful for this support because without it we had never achieved what we could achieve until today. Nowadays we are the only drug policy and practice orientated network, covering the European Union, also involving EU neighbouring countries. As a network, we aim to facilitate exchange, capacity building, and advocacy for harm reduction. For this reason, we collaborate with a lot of partner networks and stakeholders, including EU agencies and research institutes.
C-EHRN published the first monitoring report recently. Is this a shadow report competing with the EMCDDA annual report?
It’s not a shadow report, but the purpose indeed is to provide insights into the situation on certain aspects of harm reduction – hepatitis C, new drug trends, and overdose prevention – from the viewpoint of service providers and grassroots organisations. Official data can get a reality check with responses from real life experiences and the results will indicate gaps and needs for improvement. It cannot provide representative data however and that’s not the aim anyway. EMCDDA acknowledged the (potential) usefulness of our data collection and supports our efforts.
One of the key focuses of the report is the involvement of civil society. How do you see the situation in this regard in Europe?
It’s very interesting to look into this and to compare the situations in the different European countries. Acknowledged on paper by many national governments and European bodies, civil society involvement in drug policy is an ongoing challenge in most of the countries. You can see different levels of such involvement, from simple information exchange to reliable partnerships. Again, we think that civil society involvement is an essential element of a good and effective drug policy and we will continue to advocate for that.
Another thematic focus is hepatitis C. We know that we have the cure of HCV and everybody could be easily treated. But it doesn’t happen very fast. How does the report assess the systematic barriers to access HCV prevention and treatment?
Yes, with the exciting developments with regards to treatment, we think harm reduction has a very important role to play when it comes to hepatitis C elimination. Nowadays, people who inject drugs are the main driver of the epidemic, due to missing harm reduction measures, discrimination, and barriers to access. At the same time, the situation is changing and we see also a lot of improvements. With the monitoring, we would like to know what is the current role of harm reduction and grassroots organisations in the cascade of care, what support organisations are able to offer, where are the gaps and what are the developments year by year.
Many people fear that the overdose epidemic can come to Europe too. Is there any sign it will do? Is Europe prepared to fight overdoses in an effective way?
We’re speaking about more than 8000 fatal overdose cases in 2018 in the EU according to EMCDDA data, so we have a serious problem here already. But even if there are indications that fentanyl has reached the market in some regions of Europe and the number of overdoses has increased in recent years, we cannot speak about an overdose epidemic yet. We think many countries with a relatively well structured infrastructure on harm reduction are better prepared than e.g. the US, but the response needs to be well organised, comprehensive, and inclusive. In other words, there is a lot to do to tackle overdoses anyway.
The report has a chapter on monitoring new drug trends. What are the findings of the report on this?
To monitor new drug trends is challenging and we still discuss how to make the most use of our data. The report will describe trends and indicative examples rather than providing timely and representative data about new substances and it’s consequences for harm reduction. In this field we apply a ‘learning by doing’ approach.
From this report it seems there is a lot to do for decision makers. But what we see at the EU level (and in many countries) is that there is less funding and political support for harm reduction. Drug policy in general is not a priority for the EU any more. What can you do to change this situation?
We continue to rise the voice of harm reduction on all possible levels: in the community, under service providers, under policy makers, politicians on a national and European level. It is unquestionable that harm reduction is an evidence based, effective, and holistic policy and that is acknowledged by major stakeholders, supported by countless studies and daily practice. That is the point we have to make day by day.
Interview by Peter Sarosi